Table 3

OR of responding positively in 2009 compared to baseline by adoption category for HSOPS items reflecting four components of safety culture

Early adopter (n ranges from 296–317)†Early/late majority (n ranges from 636–684)†Laggard (n ranges from 177–190)†
Mean % positiveMean % positiveMean % positive
HSOPS dimensions and items by components of cultureOR (95% CI)Baseline2009OR (95% CI)Baseline2009OR (95% CI)Baseline2009
Reporting culture
 Frequency of events reported
  D1. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?‡1.13 (0.85 to 1.49)62651.01 (0.84 to 1.22)57570.85 (0.60 to1.21)4541
Just culture
 Non-punitive response to error
  A16. Staff worry that mistakes they make are kept in their personnel file§1.28 (1.00 to 1.65)48541.09 (0.92 to 1.30)51531.05 (0.75 to 1.45)4344
Flexible culture
 Teamwork within departments
  A11. When one area in this department gets really busy, others help out¶1.21 (0.89 to 1.63)73771.32** (1.09 to 1.61)68740.82 (0.58 to 1.16)6661
Staffing
 A14. We work in ‘crisis mode’ trying to do too much, too quickly§1.67** (1.18 to 2.36)64751.19 (0.95 to 1.49)63671.02 (0.67 to 1.57)6667
Communication openness
C4. Staff feel free to question the decisions and actions of those with more authority¶1.18 (0.92 to 1.52)51551.26** (1.06 to1.49)45500.84 (0.60 to 1.16)4642
Hospital handoffs and transitions
 F5. Important patient care information is often lost during shift changes§1.00 (0.77 to 1.30)61610.99 (0.83 to 1.18)54540.64* (0.46 to 0.90)5544
 F7. Problems often occur in the exchange of information across hospital departments§0.73* (0.56 to 0.94)64561.01 (0.85 to 1.19)49490.71* (0.51 to 0.98)4940
Learning culture
 Organisational learning
  A9. Mistakes have led to positive changes here¶1.45* (1.05 to 1.99)75811.29* (1.05 to 1.57)68731.29 (0.90 to 1.83)6065
 Hospital management support for patient safety
  F9. Hospital management seems interested in patient safety only after an adverse event happens§1.37 (1.00 to 1.88)77821.15 (0.95 to 1.38)68711.25 (0.89 to 1.74)5863
 Overall perceptions of safety
 A10. It is just by chance that more serious mistakes don't happen around here§1.30 (0.95 to 1.77)78821.28* (1.06 to 1.56)72771.00 (0.72 to 1.39)6161
Item aggregate65.368.859.562.554.952.8
  • *p<0.05.

  • **p<0.01.

  • †As 1–4% of item-level data are missing at random, the n for an item varies slightly within each adopter category.

  • ‡Most of the time and always are positive responses.

  • §Strongly disagree and disagree are positive responses.

  • ¶Agree and strongly agree are positive responses.

  • HSOPS, hospital survey on patient safety culture.